October 4, 2012

Jeff Raikes on Philanthropy

Welcome to my new blog
series on Impatient Optimists, where I’ll be sharing my thoughts on the Gates
Foundation and philanthropy. Every six weeks I’ll be posting a new blog
discussing a pressing issue at the foundation or addressing some of the
challenges and opportunities facing the philanthropic community. More than
anything else, this is a space for a conversation. So please submit your
questions, share your feedback, and let me know if there are any topics you
would like to hear about.

For my first post, I
want to discuss a challenge at the foundation that’s been on my mind lately.
It’s called the “innovation pile up”. Let me explain.

At the Gates Foundation, we believe in the power of
innovation to improve lives. That’s why over the last decade we’ve invested in one
of the fattest pipelines of lifesaving technologies the health and development
world has ever seen. A new, rapid diagnostic test for tuberculosis that will
help reduce transmission of the disease. Better tools to enable women to plan
their families. Even improved toilets that provide clean sanitation for the
world’s poorest people. In all, the foundation and its partners have developed
more than 100 new innovations that are available today or scheduled to be
introduced by the end of the decade.

That’s the good news.

Here’s the bad news:None of these innovations will make a difference if they can’t reach the
people we aim to serve.

Many obstacles stand in their way. Some public health
systems in the developing world lack staff, training, or infrastructure to take
advantage of these new tools and technologies. Regulatory agencies can be slow
to approve new drugs and devices. Market forces may make it difficult to
introduce these new products. Then, there are actual roadblocks. Transportation
systems and roadways may be so bad – or nonexistent -- that just getting these
new tools safely to the people who need them is a challenge. Finally, even if
new drugs and tools arrive in remote villages, cultural practices may dissuade
people from adopting them.

That’s why we need to get smarter at delivering these
innovations. If we don’t, we risk not improving and saving as many lives as we
could.

At the foundation, this challenge has been dubbed the
“innovation pile-up,” and solving it is one of my top priorities. As part of the
re-organization of our global programs, which I outlined in my 2011 Annual
Report letter, we are now balancing our research and development efforts with a
greater focus on how these innovations will get delivered. Chris Elias, our new
president of Global Development, brings decades of on-the-ground experience in
heath and development. He is leading our work to better understand the
obstacles to introducing and scaling access to new tools and technologies and
how we can overcome them.

We’ve already learned a lot about effective delivery from
our work on vaccines. We have a better understanding of the best funding
mechanisms for new vaccines and the most reliable ways to deliver them safely
to the remotest health clinics. Thanks to these efforts we are on track to
significantly scale up the delivery of lifesaving vaccines in developing
countries and prevent the deaths of millions of children under 5 by the end of
the decade.

Now we need to build on this success and ensure other
promising technologies reach the people who need them the most. We are
exploring ways to integrate some of these new innovations into existing
delivery systems. For example, a new, easy-to-use injectable contraceptive that
would provide women living in remote areas a simple, effective family planning
tool will likely be introduced through family planning programs already
operating in these countries.

Other existing innovations will require new delivery systems
and business models to be successful. Consider the challenge of expanding
access to a simple, lifesaving product like the mosquito coil. The
spiral-shaped, insect-repelling incense has the potential to protect families
from malaria-carrying mosquitoes. But the cost – even at pennies per day –
remains out of financial reach for many of the world’s poorest families. Donors
may be able to help drive down the costs for these families, but there hasn’t
been much interest in this solution without more data on the impact of
wide-scale coil use. That’s why we’re working to fill this knowledge gap by
funding new research studies. We’re also exploring next-generation mosquito
repellents that would last for months, cost less, and not require burning. All
of these solutions will require the cooperation and partnership of governments,
the private sector, and consumers to be successful.

These are tough challenges. But I’m confident we can
overcome them. We now have a team dedicated to speeding up the delivery of
existing innovations and finding new system delivery models for entirely new
innovations. More importantly, we will be listening closely to the people who
will benefit from these innovations. By understanding their needs, we can
design the best solutions and most effective ways of delivering them. Working
together, we will realize the full potential of these innovations, and, in
doing so, help the people we serve realize the full potential of their own
lives.